IndividualActive
Lisa Jack
NPI 1053041830 · Specialist · Wichita, KS
Lisa Jack is a Specialist provider in Wichita, KS (NPI 1053041830).
Provider details
- NPI number
- 1053041830
- Entity type
- Individual
- Primary specialty
- SpecialistOther Service Providers
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Other Service Providers
Profile Score
Established profile(54/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
8625 E 37th St N Ste 101
Wichita, KS 67226-2008
Phone: (316) 648-8545
Street-level locationGet directions
Mailing address
5709 E 17th St N
Wichita, KS 67208-1703
Registry dates
- Enumerated
- 2022-06-14
- Last updated
- 2022-06-14
- Certified
- 2022-06-14
Frequently asked questions
- What is Lisa Jack's NPI number?
- Lisa Jack's National Provider Identifier (NPI) is 1053041830, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Lisa Jack's specialty?
- Lisa Jack is listed in the NPPES registry with a primary specialty of Specialist (Other Service Providers).
- Where is Lisa Jack located?
- Lisa Jack's practice location on file with NPPES is 8625 E 37th St N Ste 101, Wichita, KS 67226-2008.
- What is Lisa Jack's phone number?
- The practice phone number listed in the NPPES registry for Lisa Jack is (316) 648-8545.
- Is Lisa Jack's NPI active?
- Yes — Lisa Jack's NPI (1053041830) is active in the NPPES registry as of the last update on 2022-06-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.